Decision‐Making Fairness and Consensus Building in Multisector Community Health Alliances: A Mixed‐Methods Analysis

Given their inherently diverse composition and potentially competing interests, a foundational activity of community health alliances is establishing consensus on the vision and strategies for achieving its goals. Using an organizational justice framework, we examined whether member perceptions of fairness in alliances' decision‐making processes are associated with the perceived level of consensus among members regarding the alliance vision and strategies. We used a mixed‐methods design to examine the relationship between perceptions of fairness and consensus within fourteen multisector community health alliances. Quantitative analysis found the perceived level of consensus to be positively associated with decision‐making transparency (procedural fairness), inclusiveness (procedural fairness), and benefits relative to costs (distributive fairness). Qualitative analysis indicated that the consensus‐building process is facilitated by using formal decision‐making frameworks and engaging alliance members in decision‐making processes early. Alliance leaders may be more successful at building consensus when they recognize the need to appeal to a member's sense of procedural and distributive fairness, and, perhaps equally important, recognize when one rather than the other is called for and draw upon decision‐making processes that most clearly evoke that sense of fairness. Our findings reinforce the importance of fairness in building and sustaining capacity for improving community health.     

Data envelopment analysis 1978–2010: A citation-based literature survey

This study surveys the data envelopment analysis (DEA) literature by applying a citation-based approach. The main goals are to find a set of papers playing the central role in DEA development and to discover the latest active DEA subareas. A directional network is constructed based on citation relationships among academic papers. After assigning an importance index to each link in the citation network, main DEA development paths emerge. We examine various types of main paths, including local main path, global main path, and multiple main paths. The analysis result suggests, as expected, that Charnes et al. (1978) [Charnes A, Cooper WW, Rhodes E. Measuring the efficiency of decision making units. European Journal of Operational Research 1978; 2(6): 429–444] is the most influential DEA paper. The five most active DEA subareas in recent years are identified; among them the “two-stage contextual factor evaluation framework” is relatively more active. Aside from the main path analysis, we summarize basic statistics on DEA journals and researchers. A growth curve analysis hints that the DEA literature’s size will eventually grow to at least double the size of the existing literature.     

Assessing Potential Human Health Hazards and Benefits from Subtherapeutic Antibiotics in the United States: Tetracyclines as a Case Study

Many scientists, activists, regulators, and politicians have expressed urgent concern that using antibiotics in food animals selects for resistant strains of bacteria that harm human health and bring nearer a “postantibiotic era” of multidrug resistant “super‐bugs.” Proposed political solutions, such as the Preservation of Antibiotics for Medical Treatment Act (PAMTA), would ban entire classes of subtherapeutic antibiotics (STAs) now used for disease prevention and growth promotion in food animals. The proposed bans are not driven by formal quantitative risk assessment (QRA), but by a perceived need for immediate action to prevent potential catastrophe. Similar fears led to STA phase‐outs in Europe a decade ago. However, QRA and empirical data indicate that continued use of STAs in the United States has not harmed human health, and bans in Europe have not helped human health. The fears motivating PAMTA contrast with QRA estimates of vanishingly small risks. As a case study, examining specific tetracycline uses and resistance patterns suggests that there is no significant human health hazard from continued use of tetracycline in food animals. Simple hypothetical calculations suggest an unobservably small risk (between 0 and 1.75E‐11 excess lifetime risk of a tetracycline‐resistant infection), based on the long history of tetracycline use in the United States without resistance‐related treatment failures. QRAs for other STA uses in food animals also find that human health risks are vanishingly small. Whether such QRA calculations will guide risk management policy for animal antibiotics in the United States remains to be seen.     

Nano Risk Analysis: Advancing the Science for Nanomaterials Risk Management

Scientists, activists, industry, and governments have raised concerns about health and environmental risks of nanoscale materials. The Society for Risk Analysis convened experts in September 2008 in Washington, DC to deliberate on issues relating to the unique attributes of nanoscale materials that raise novel concerns about health risks. This article reports on the overall themes and findings of the workshop, uncovering the underlying issues for each of these topics that become recurring themes. The attributes of nanoscale particles and other nanomaterials that present novel issues for risk analysis are evaluated in a risk analysis framework, identifying challenges and opportunities for risk analysts and others seeking to assess and manage the risks from emerging nanoscale materials and nanotechnologies. Workshop deliberations and recommendations for advancing the risk analysis and management of nanotechnologies are presented.     

The Benefits and Costs of Using Metadata to Improve Enterprise Document Search

The literature shows that there are many problems with enterprise document search. Studies reveal that typical knowledge workers spend between 10% and 20% of their time searching for documents they never find. While many argue that metadata can improve enterprise document search, in reality few organizations use metadata. This represents a missed opportunity. This article describes the results of two experiments that use simulation to evaluate the actual impact of metadata on the costs and benefits of enterprise search. The first study provides quantitative evidence of the increase in recall and precision that stems from the use of metadata‐enhanced document searches. The second study demonstrates that simple metadata structures can be nearly as effective as complex ones, implying that the cost of creating and maintaining metadata is likely to be lower than generally thought. This is the first study to provide explicit quantitative evidence of the gains that can be achieved from the use of metadata, and one of only a handful of studies that examines the cost of creating and maintaining metadata.     

How Probabilistic Risk Assessment Can Mislead Terrorism Risk Analysts

Traditional probabilistic risk assessment (PRA), of the type originally developed for engineered systems, is still proposed for terrorism risk analysis. We show that such PRA applications are unjustified in general. The capacity of terrorists to seek and use information and to actively research different attack options before deciding what to do raises unique features of terrorism risk assessment that are not adequately addressed by conventional PRA for natural and engineered systems—in part because decisions based on such PRA estimates do not adequately hedge against the different probabilities that attackers may eventually act upon. These probabilities may differ from the defender's (even if the defender's experts are thoroughly trained, well calibrated, unbiased probability assessors) because they may be conditioned on different information. We illustrate the fundamental differences between PRA and terrorism risk analysis, and suggest use of robust decision analysis for risk management when attackers may know more about some attack options than we do.     

MONITORING IN TEAMS: USING LABORATORY EXPERIMENTS TO STUDY A THEORY OF THE FIRM

Alchian and Demsetz’s influential explanation of the classical business firm (The American Economic Review, 1972, 62, 777–795) argues that there is need for a concentrated residual claim in the hands of a central agent, to motivate the monitoring of workers. We model monitoring as a way to transform team production from a collective action dilemma with strong free riding incentives to a productivity‐enhancing opportunity with strong private marginal incentives to contribute effort. In an experiment, we have subjects experience team production without monitoring, team production with a central monitor, and team production with peer monitoring. Then subjects vote on whether to employ the central monitor, who gets to keep a fixed share of the team output, or to rely on peer monitoring, which entails a coordination or free riding problem. Our subjects usually prefer peer monitoring but they switch to the specialist when unable to successfully self‐monitor. We provide evidence for situations in which team members resist the appointing of a central monitor and succeed in overcoming coordination and free riding problems as well as for a situation in which an Alchian–Demsetz‐like firm grows in the laboratory.     

On the definition and varieties of attitude and wellbeing

In a paper published in Social Indicators Research in 1975, Levy and Guttman proved the proposition that wellbeing is a special case of attitude. They exploited this result for establishing a certain lawfulness for wellbeing behavior, and built on this for revealing more specialized features of the lawfulness. Five years later in this same journal, Andrews and McKennell published two papers on exactly the same proposition, but without proving it, without building on known relevant lawfulness of attitudinal behavior, and without mentioning (neither positively nor negatively) the Levy-Guttman work. The Andrews-McKennell papers are shown to be a retrogression rather than a scientific advance, being conceptually confused, using inappropriate data analysis, and dealing with arbitrary assumptions which are either untested, untestable or false.     

Properties of a generalized source-to-all-terminal network reliability model with diameter constraints

Given the pervasive nature of computer and communication networks, many paradigms have been used to study their properties and performances. In particular, reliability models based on topological properties can adequately represent the network capacity to survive failures of its components. Classical reliability models are based on the existence of end-to-end paths between network nodes, not taking into account the length of these paths; for many applications, this is inadequate, because the connection will only be established or attain the required quality if the distance between the connecting nodes does not exceed a given value.An alternative topological reliability model is the diameter-constrained reliability of a network; this measure considers not only the underlying topology, but also imposes a bound on the diameter, which is the maximum distance between the nodes of the network. In this work, we study in particular the case where we want to model the connection between a source-vertex s and a set of terminal vertices K (for example, a video multicast application), using a directed graph (digraph) for representing the topology of the network with node set V. If the s,K-diameter is the maximum distance between s and any of vertices of K, the diameter-constrained s,K-terminal reliability of a network G, R_s,K(G,D), is defined as the probability that surviving arcs span a subgraph whose s,K-diameter does not exceed D.One of the tools successfully employed in the study of classical reliability models is the domination of a graph, which was introduced by Satyanarayana and Prabhakar. In this paper we introduce a definition and a full characterization of the domination in the case of the diameter-constrained s,K-terminal reliability when K=V, including the classical source-to-all-terminal reliability domination result as a specific case. Moreover we use these results to present an algorithm for the evaluation of the diameter-constrained s,V-terminal reliability R_s,V(G,D).